Shelly’s daughter, Samantha Swartwout, was not in a booster car seat when her husband’s car veered off the road and into a tree on September 17th. Samantha had wiggled out of the seat belt, which caused it dig into her abdomen on impact.

The force caused the belt to shred the muscle and fat underneath and slice through on her left side, leaving inches of her intestine outside her belly.

“The child is thrown forward with an absolutely enormous force. The seat belt almost acts like a knife,” said Dr. Charles Bagwell, chair of pediatric surgery at Children’s Hospital of Richmond at VCU, who treated Samantha.

Despite spending three weeks in the hospital, Samantha still needs to return for another surgery to completely repair the damage.

“She has so many limitations,” said Martin. “She’ll try to build a fort with her blankets but she can’t because she can’t bend over. She will cry; ‘How can other kids do this?’ and ‘When will I be normal?'”

A booster seat’s job is to position the seat belt to rest correctly on a child’s body.

The lap belt must sit across the hip bones while the harness goes over the shoulder and across the middle of the chest. Without the booster, the belt rises up and crosses the stomach. This means if there’s a crash the belt fails to restrain a child and instead causes injuries.

“Putting the shoulder belt behind the back is a huge no-no,” said Corri Miller-Hobbs, a nurse and program coordinator with Safe Kids Virginia, told TODAY. “Everybody needs to have a lap and shoulder belt. That same injury could occur to any one of us.”

Children should stay in a five-point harness car seat until they weigh up to 70 pounds, depending on the brand. Some brands like Britax and Diono offer seats that will hold a child in 5-point until they are 80lbs and 90lbs respectively. This is the safest option for kids because the harness hugs your child’s body and doesn’t tighten and loosen like a classic car seat belt. This means there isn’t a risk of them being thrown from the vehicle in the event of an accident.

All parents should check out Safe Kids’ Ultimate Car Seat guide. Parents can get personalized advice about when their children need to be in a car seat, a booster seat, or can go without one.

As the family plans for their daughter’s next surgery they hope others will take the time to buckle a child correctly.

“This is her entire first grade gone. She is missing out on a lot,” she said. “It is basically a trade off. Do you want to take the two seconds to strap your child correctly or do you want to deal with all of this?”